Music · Connection · Wellbeing

Register as a participant

This is a one-time registration so we have what we need to welcome you and keep you supported. It takes a few minutes. Everything is stored securely and only seen by authorised staff, and photo or video permissions are a separate form so you stay in control of those.

About you

Full name *

Preferred name

Date of birth *

Postcode

Address

How we reach you

Phone

Preferred contact method

Email Phone call Text message

Please give us at least an email or a phone number.

Emergency contact

Name

Relationship to you

Contact number

Support, access & health

Any accessibility or communication needs?

Allergies

Any relevant health information

Music & interests

Which sessions or activities are you interested in?

Instruments you play or previous experience

Permissions

Photo, video, audio and testimonial permissions are a separate consent form, so you stay in control of those choices.

Confirm & sign

Type your full name to sign *

This is dated automatically when you submit.